Geographic variations of predominantly hepatitis C virus associated male hepatocellular carcinoma townships in Taiwan: Identification of potential high HCV endemic areas

Purpose: The proportion of B-HCC cases in Taiwan has progressively decreased over the last 20 years. It was not really due to an overall decrease in B-HCC but due to an increase in HCV-related HCC. The identification of potential HCV endemic areas in Taiwan has consequently become important. Methods: Data were collected retrospectively from eight Taiwan medical centers from 1981 to 2001, the geographical variations of male C-HCC townships in Taiwan were illustrated on maps. Goodness of fit was used to compare the anti-HCV prevalence in townships and cities, with the mean anti-HCV prevalence for Taiwan as a whole. Township-, city-, and county-specific prevalence of anti-HCV was presented as the median, ranges, and SMRs. Results: Geographic variation can be analyzed in only 263 townships and cities. The maps were designed on the basis of different SMRs. The mean anti-HCV prevalence for male HCC patients in Taiwan was 31.9% (95% confidence interval: 30.7-33.0). Twenty-five townships distributed throughout central-western and south-western Taiwan have significantly higher prevalence (P < 0.05) (12 townships SMR ≥ 2; 13 townships 1.5 ≤ SMR < 2). Twenty-two townships have significantly lower prevalence (P < 0.05) (6 townships 0.5 ≤ SMR<1; 16 townships SMR < 0.5). Four different patterns of geographic variation in different counties were also noted and demonstrated. Conclusion: We successfully highlighted some potential high HCV endemic townships in Taiwan. © 2009 Asian Pacific Association for the Study of the Liver.